Prevalence, severity, associated factors and assessment of risk for falls among elderly in Sri Lanka

Background: Falls among the elderly is a significant global health problem. Therefore, we aimed to study the prevalence, severity, and factors associated with falls among community-dwelling elders and assess their future risk of falls.Methods: A descriptive cross-sectional study was conducted among 128 residents aged ≥65 years from a housing complex in Colombo, Sri Lanka. Participants were selected using systematic sampling. Data were obtained using an interviewer-administered questionnaire. Disability, cognition and future falls risk were assessed using the modified Rankin scale (mRS), the Montreal Cognitive Assessment (MoCA) tool and the QuickScreen (QS) tool, respectively.Results: Among the participants, 54.7% were aged 65-74 years and 55.5%were women. Prevalence of falls was 44.5% in the last five years and 17.2% in the last one year. Of those who fell, 2.4% had significant disability (mRS≥3) and 63.2% required medical attention. Cognitive impairment (MoCA<26/30) was found among 84.4%. Diabetes (36.7%), hypertension (60.9%), backache (59.4%), obesity (65.6%), impaired mobility and vision impairment (71.9%) were the identified biological risk factors. Slippery floors (38.3%) were the commonest environmental risk factor. Among the participants 35.9% were taking >3 types of medications. In the mobility tests, 66.4% failed the alternate step test, 64.1% failed the sit to stand test while 25% failed the near tandem test. Based on the QS scores, the fall risk in the ensuing 12 months was found to be high in seven participants (5.5%), moderate in 86 (67.1%) and low in 35 (27.3%).Conclusion: Falls among elderly were common and was associated with significant morbidity. Many elders possessed more than one risk factor for falls and the future falls risk was found to be moderate to high.